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Biomedical subjects

B Koletzko

Publications and source records attributed to B Koletzko.

At least 37 records · Page 2Linked to original sources
PubMed2001

Influence of formulas with borage oil or borage oil plus fish oil on the arachidonic acid status in premature infants.

Several studies have reported that feeding gamma-linolenic acid (GLA) has resulted in no increase in arachidonic acid (AA) in newborns. This result was ascribed to the eicosapentaenoic acid (EPA)-rich fish oil used in these formulas. Docosahexaenoic acid (DHA) sources with only minor amounts of EPA are now available, thus the addition of GLA to infant formulas might be considered an alternative to AA supplementation. Sixty-six premature infants were randomized to feeding one of four formulas [ST: no GLA, no long-chain polyunsaturated fatty acids; BO: 0.6% GLA (borage oil); BO + FOLOW: 0.6% GLA, 0.3% DHA, 0.06% EPA; BO + FOHIGH: 0.6% GLA, 0.3% DHA, 0.2% EPA] or human milk (HM, nonrandomized) for 4 wk. Anthropometric measures and blood samples were obtained at study entry and after 14 and 28 d. There were no significant differences between groups in anthropometric measures, tocopherol, and retinol status at any of the studied time points. The AA content of plasma phospholipids was similar between groups at study start and decreased significantly until day 28 in all formulafed groups, but not in the breast-fed infants [ST: 6.6 +/- 0.2%, BO: 6.9 +/- 0.3%, BO + FOLOW: 6.9 +/- 0.4%, BO + FOHIGH: 6.7 +/- 0.2%, HM: 8.6 +/- 0.5%, where values are reported as mean +/- standard error; all formulas significantly different (P< 0.05) from HM]. There was no significant influence of GLA or fish oil addition to the diet. GLA had only a very limited effect on AA status which was too small to obtain satisfactory concentrations (concentrations similar to breast-fed babies) under the circumstances tested. The effect of GLA on AA is independent of the EPA and DHA content in the diet within the dose ranges studied.

Antioxidants↗
PubMed2001

Polyunsaturated fatty acid supply with human milk.

Polyunsaturated fatty acids in human milk may derive from diet, liberation from maternal body stores, or endogenous synthesis from precursor fatty acids. The contribution of each of these sources has not been studied in detail. Although maternal diet is a key factor affecting human milk composition, other factors such as gestational age, stage of lactation, nutritional status, and genetic background are known to influence the fat content and fatty acid composition in human milk. Both linoleic and alpha-linolenic acids, the essential fatty acids, are present in human milk, as are several other n-6 and n-3 longer chain polyunsaturated fatty acids that are required for optimal growth and development of infants. The fatty acid profile of human milk from lactating women of different countries is remarkably stable, but there is variability in some of the components, such as docosahexaenoic acid, which is mainly due to differences in dietary habits. Tracer techniques with stable isotopes have been valuable in assessing the kinetics of fatty acid metabolism during lactation and in determining the origin of fatty acids in human milk. Based on these studies, the major part of polyunsaturated fatty acids in human milk seems not to be provided directly from the diet but from maternal tissue stores.

Clinical Trials as Topic↗
PubMed2001

Physiological aspects of human milk lipids.

Human milk from healthy and well-nourished mothers is the preferred form of feeding for all healthy newborn infants. The nutrient supply with human milk supports normal growth and development of the infant. Here the general characteristics of human milk lipids and recent knowledge on lactational physiology, composition and functional aspects of human milk lipids are discussed. Lipids in human milk represent the main source of energy for the breastfed baby and supply essential nutrients such as fat-soluble vitamins and polyunsaturated fatty acids (PUFA). The essential fatty acids linoleic and alpha-linolenic acids (LA and ALA) are precursors of long-chain polyunsaturated fatty acids (LC-PUFA), including arachidonic (20:4n-6) and docosahexaenoic (22:6n-3) acids (AA and DHA). LC-PUFA serve as indispensable structural components of cellular membranes and are deposited to a considerable extent in the growing brain and the retina during perinatal development. The supply of preformed LC-PUFA with human milk lipids has been related to functional outcomes of the recipient infants such as visual acuity and development of cognitive functions during the first year of life. Recent stable isotope studies indicate that the major portion of milk PUFA is not derived directly from the maternal diet, but stems from endogenous body stores. Thus, not only the woman's current but also her long-term dietary intake is of marked relevance for milk fat composition.

Diet↗
PubMed2001

Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet.

BACKGROUND: Polyunsaturated fatty acids in milk are derived from direct intestinal absorption, endogenous synthesis, or maternal body stores. Arachidonic acid (AA) intake is frequently low in undernourished women, but milk secretion of this fatty acid is similar to that in well-nourished women. OBJECTIVE: The objective was to evaluate the contribution of dietary and endogenously synthesized AA to its total secretion in the milk of women eating a low-fat diet. DESIGN: Ten lactating women who habitually ate a low-fat diet (17% of energy) received 2.5 mg [(13)C]linoleic acid (LA)/kg body wt orally 5 mo postpartum. LA and AA concentrations and (13)C enrichment were measured in milk samples collected before and after the tracer application. Total lipid, LA, and AA contents were determined in diet composites. Fatty acids were assessed by gas chromatography and (13)C enrichment by isotope ratio mass spectrometry. RESULTS: The cumulative 72-h recovery of [(13)C]LA in milk was 16.3 +/- 6.4% of the dose; only 0.01% of the label was found as [(13)C]AA. The calculated transfer of dietary LA and AA into milk was 32.8 +/- 18.0% and 11.8 +/- 6.6%, respectively. AA originating from conversion of dietary LA contributed only 1.1% to the total milk AA secreted. CONCLUSIONS: Little milk AA originates from conversion of LA; 70% of LA and 90% of AA secreted in milk were not derived from direct intestinal absorption. Our results suggest that maternal body stores are the major source of milk LA and AA in these women.

Adult↗
PubMed2001

[13C]linoleic acid oxidation and transfer into milk in stunted lactating women with contrasting body mass indexes.

BACKGROUND: The fat concentration of human milk is associated with maternal adiposity, but there is no clear understanding of the mechanisms controlling milk fat concentration. OBJECTIVE: We evaluated the effect of postpartum body mass index (BMI; in kg/m(2)) on the metabolic distribution of an oral dose of [13C]linoleic acid in lactating women. DESIGN: Ten lactating women stratified by BMI (either <22.5 or >23.5) at 5 mo postpartum received orally 2.5 mg [13C]linoleic acid/kg body wt. Exhaled air, milk, and plasma samples were collected in relation to tracer administration. Linoleic acid was determined by gas chromatography. Dietary intake, serum, milk composition, [13C]linoleic acid enrichment in milk and plasma, and exhaled 13CO2 (by isotope ratio mass spectrometry) were assessed. RESULTS: Women with a higher BMI exhaled more 13CO2 than did women with a lower BMI (22.8 +/- 9.4% compared with 8.6 +/- 3.5% of dose, P < 0.03). Cumulated 72-h transfer of [13C]linoleic acid to milk was not significantly different between groups (14.8 +/- 6.5% compared with 17.7 +/- 6.7% of dose). Within the first 9 h after dose administration, 51.6 +/- 4.9% of the total isotope transfer into milk had passed in women with a higher BMI, but only 24.0 +/- 15.3% had passed in those with a lower BMI (P = 0.02). CONCLUSIONS: Women with a lower BMI, who were reputed as having less body fat, oxidized and secreted into milk less dietary linoleic acid within 12 h after tracer administration than did women with a higher BMI. In both groups, a large proportion of [13C]linoleic was retained in the maternal compartment, most likely fat tissue, in a slow turnover pool, and released slowly in later hours.

Adipose Tissue↗
PubMed2001

Effect of elective abdominal surgery on human colon protein synthesis in situ.

OBJECTIVE: To determine the effect of elective abdominal surgery on the rate of human colon fractional protein synthesis in situ. SUMMARY BACKGROUND DATA: Efficient intestinal protein synthesis plays an important role in the physiology and pathophysiology of the intestinal tract, allowing preservation of gut integrity and thereby preventing bacterial or endotoxin translocation. Because of species differences, animal studies have only limited applicability to human intestinal protein metabolism, and because of methodologic restrictions, no studies on colon protein synthesis in situ are available in humans. METHODS: The authors used advanced mass spectrometry techniques (capillary gas chromatography and combustion isotope ratio mass spectrometry) to determine directly the incorporation rate of 1-[13C]-leucine into colon mucosal protein in control subjects and nonseptic postoperative patients. All subjects had a colostomy, which allowed easy access to the colon mucosa, and consecutive sampling from the same tissue was performed during continuous isotope infusion (0.16 micromol/kg per minute). RESULTS: Control subjects demonstrated a colon protein fractional synthetic rate of 0.74 +/- 0.09% per hour. In postsurgical patients, colon protein synthesis was significantly higher and the tissue free leucine enrichment was significantly lower, compatible with an increased colon proteolytic rate. CONCLUSIONS: Elective abdominal surgery followed by an uncomplicated postoperative course is associated with a stimulation of colon protein synthesis and possibly also of protein degradation. The postoperative rate of colon protein synthesis is, compared with other tissues, among the highest measured thus far in humans.

Aged↗
PubMed2001

Fatty acid composition of plasma lipids in healthy Portuguese children: is the Mediterranean diet disappearing?

BACKGROUND: Adults and children in Mediterranean countries are believed to consume a Mediterranean-type diet which is higher in monounsaturated and n-3 polyunsaturated fatty acids than compared to central and northern parts of Europe and has preventive effects for cardiovascular risks. SUBJECTS AND METHODS: In preschool children from Porto, Portugal (n = 35) and Munich, Germany (n = 18) we determined the plasma phospholipid fatty acid composition considered as a biomarker for dietary fat intake. RESULTS: The plasma phospholipid contents of total saturated fatty acids are similar in both groups, but the Portuguese children have lower values of monounsaturated and n-3 polyunsaturated fatty acids. The results indicate that the food habits of Portuguese children are even less close to the traditional Mediterranean diet than those of German children. CONCLUSIONS: Efforts should be made to encourage young families as well as manufacturers and distributors of food products in Portugal to emphasize traditional Mediterranean food habits, especially in young children.

Biomarkers↗
PubMed2001

Long chain polyunsaturated fatty acids (LC-PUFA) and perinatal development.

UNLABELLED: This paper reports on the conclusions of a workshop on the role of long chain polyunsaturated fatty acids (LC-PUFA) in maternal and child health. The attending investigators involved in the majority of randomized trials examining LC-PUFA status and functional outcomes summarize the current knowledge in the field and make recommendations for dietary practice. Only studies published in full or in abstract form were used as our working knowledge base. CONCLUSIONS: For healthy infants we recommend and strongly support breastfeeding as the preferred method of feeding, which supplies preformed LC-PUFA. Infant formulas for term infants should contain at least 0.2% of total fatty acids as docosahexaenoic acid (DHA) and 0.35% as arachidonic acid (AA). Since preterm infants are born with much less total body DHA and AA, we suggest that preterm infant formulas should include at least 0.35% DHA and 0.4% AA. Higher levels might confer additional benefits and should be further investigated because optimal dietary intakes for term and preterm infants remain to be defined. For pregnant and lactating women we consider it premature to recommend specific LC-PUFA intakes. However, it seems prudent for pregnant and lactating women to include some food sources of DHA in their diet in view of their assumed increase in LC-PUFA demand and the relationship between maternal and foetal DHA status.

Animals↗
PubMed2000

Beer and breastfeeding.

Traditional wisdom claims that moderate beer consumption may be beneficial for initiation of breastfeeding and enhancement of breastfeeding success. Here we review the question whether or not there is any scientific basis for this popular belief. There are clear indications that beer can stimulate prolactin secretion which may enhance lactogenesis both in non-lactating humans and in experimental animals. The component in beer responsible for the effect on prolactin secretion is not the alcohol content but apparently a polysaccharide from barley, which explains that the effect on prolactin can also be induced by non-alcoholic beer. No systematic studies are available to evaluate the clinical effects of beer on induction of lactogenesis, and short term studies have shown a reduced breast milk intake by infants after moderate alcohol consumption of their mothers. It is conceivable that relaxing effects of both alcohol and components of hop might also have beneficial effects on lactogenesis is some women, but there is no hard evidence for causal effects. It appears prudent not to generally advocate the regular use of alcoholic drinks during lactation but to rather refer mothers to non-alcoholic beer, even though no adverse effects of an occasional alcoholic drink during lactation have been documented.

Beer↗
PubMed2000

Transition of nitro musks and polycyclic musks into human milk.

Synthetic musks are widely used in various consumer products. The identification of nitro musks in human milk in the early 1990s in connection with evidence for cancerogenicity in animal experiments have caused public concern. However, the validity of previously reported quantitative data has been questioned. Polycylic musks have hardly been investigated so far. The present study aimed at providing accurate current data on the occurrence of nitro and polycyclic musks in human milk. Samples from 40 healthy breast feeding mothers were analysed under carefully controlled conditions avoiding secondary contamination. As in earlier studies, among the nitro compounds musk xylene and ketone were the most frequently detected substances. However, much lower concentrations (roughly by a factor of 10) were found (musk xylene: median 6.1 ng/kg fat). Among the polycylic musks HHCB was found in most samples (median 64 ng/kg fat). Scientific knowledge on possible routes of exposure and health risk aspects is summarized and discussed.

Adult↗
PubMed2000

Does breast-feeding protect against childhood obesity?

The impact of breast-feeding on overweight and obesity in children at school entry was assessed in a cross sectional study in Bavaria in 1997. The school entry health examination enrolled 134,577 children. Data on early feeding were collected in two rural districts (eligible population n=13,345). The analyses were confined to 5 or 6 year old children with German nationality. The main outcome measures were overweight (BMI>90th percentile for all German children seen at the 1997 school entry health examination in Bavaria) and obesity (BMI>97th percentile). Information on breast-feeding was available for 9206 children of whom 56% had been breast-fed for any length of time. In non breast-fed children the upper tail of the BMI distribution was enlarged as compared to the breast-fed children whereas the median was almost identical. The prevalence of obesity in children who had never been breast-fed was 4.5% as compared to 2.8% in ever breast-fed children. A clear dose response effect for the duration of breast-feeding on the prevalence of obesity was found: 3.8%, 2.3%, 1.7% and 0.8% for exclusive breast-feeding for up to 2, 3 to 5, 6 to 12 and more than 12 months, respectively. The results for overweight were very similar. The protective effect of beast feeding on overweight and obesity could not be explained by differences in social class or lifestyle. The adjusted odds ratios of breast-feeding for any length of time was 0.71 (95% CI 0.56-0.90) for obesity and 0.77 (95%CI 0.66-0.88) for overweight. This data set did not allow to adjust for maternal weight, an important risk factor for obesity in children. Maternal overweight, however, could not explain the effect of breastfeeding on overweight and obesity in a similar study. The reduction in the risk for overweight and obesity is therefore more likely to be related to the properties of human milk than to factors associated with breast-feeding. The potential relevance of different components of human milk for the observed reduction in the risk for overweight and obesity is discussed. The preventive effect of breast-feeding on overweight and obesity is an important additional argument for the promotion of breast-feeding in industrialised countries.

Body Mass Index↗
PubMed2000

The fatty acid composition of human colostrum.

We reviewed 15 studies reporting on the fatty acid composition of colostrum lipids from 16 geographic regions: 11 European studies and one study each from Central America, the Caribbean, Australia and Asia. The contents of essential fatty acids, saturates and polyunsaturates were similar in the southern European countries Spain, Slovenia and France. Colostrum of St. Lucian women was high in saturates and low in oleic acid, reflecting a high-carbohydrate, low-fat diet. Abundant fish intake was reflected in high contents of docosahexaenoic acid and total n-3 long-chain polyunsaturated fatty acids in St. Lucia. Two French studies published with an interval of two years showed a very similar colostrum fatty acid composition, whereas two German studies obtained with an interval of 14 years showed higher docosahexaenoic acid and arachidonic acid contents in the later study, with an unchanged n-6/n-3 long-chain polyunsaturated fatty acid ratio. Studies from Spain reported a decline of alpha-linolenic acid in colostrum over a time period of 13 years. Colostrum of Australian women contained the lowest polyunsaturated/saturated and n-6/n-3 long-chain polyunsaturated fatty acids ratios (0.28 and 1.58) and the lowest contents of linoleic and alpha-linolenic acids (7.8 and 0.4 wt.%). In contrast, the contents of docosahexaenoic acid, eicosapentaenoic acid and total n-3 long-chain polyunsaturated fatty acids (0.6, 0.4 and 1.4 wt.%) were higher in Australian than in European samples. Fatty acid composition of human colostrum appears to be markedly influenced by geographic differences in maternal dietary composition.

Colostrum↗